The Chinese health authorities have confirmed two cases of pneumonic plague among Inner Mongolian villagers. One of the patients was still in a critical condition while the other patient was stable, according to an update from the Beijing health commission on Thursday morning. Eleven experts from China’s Centre for Disease Control and Prevention (CDC), as well as top hospitals, had been assembled to provide guidance and consultation on the matter, the commission’s statement said, adding that “further prevention and control measures may be taken”. The patients from the remote area of Sunite Left Banner, close to the Mongolian border, were diagnosed in Beijing on Tuesday, the Beijing Chaoyang health commission said in a previous notice. How plague in Hong Kong sowed seeds of democracy, changed urban planning and helped heal social divisions The patients were transferred to Beijing for hospital treatment using ambulances from Inner Mongolia, according to the latest notice. Personnel who were in physical proximity with them have now been placed under medical quarantine and currently do not show any abnormal symptoms. They were being treated at unnamed hospitals in the capital’s Chaoyang district and disease control measures had been taken, according to a notice published on the Chaoyang health commission’s website on Tuesday. Doctors at Chaoyang Hospital confirmed that the patients had been treated there but had since been transferred elsewhere, local media reported. On Wednesday, the CDC said that the risk of the disease spreading was “extremely low” and that “citizens can carry on with their daily lives and visit medical institutions without worrying about the risk of infection”. It added that Beijing residents need not worry about catching the disease through coming into contact with rats, since the outbreak had originated outside the capital. Pneumonic plague is a respiratory infection carried by the Yersinia pestis bacteria. This is transmitted when infected fleas bite their host animal, normally a rodent or small mammal, which then comes into contact with humans, or when an infected human comes into contact with another person. A child in Idaho was treated for bubonic plague in the first human case in the state in 26 years It is one of three strains of plague, including septicaemic and bubonic – which wiped out at least one third of the population of Europe during the Black Death and caused millions of deaths in China and India in an outbreak in the 19th century. While it is rarer than bubonic plague, pneumonic plague is the most serious form of the illness since it is extremely infectious, according to Professor Joseph Kam Kai-man, a microbiology specialist at the Chinese University of Hong Kong. Since then, there have been occasional outbreaks of pneumonic plague in remote areas of China despite its near-eradication in most parts of the country. These include 12 diagnosed cases in a town in Qinghai province in 2009 which led to three deaths, and more recently, a case in Gansu province in 2014 that resulted in one death after a herdsman came into contact with a dead marmot . Symptoms can appear after an incubation period of one to seven days after infection, and the disease has an 100 per cent mortality rate within 24 hours if left untreated. “If humans come into certain animals’ environment for, say, hunting game, they are likely to catch those bacteria from the animals,” Kam said. Plague alert in Madagascar over ‘turning’ ritual that raises the dead from their tombs “Inner Mongolia is rural, so maybe it’s a bit difficult for the CDC since it’s a vast province and not very easy to travel around – especially at this time of year. “It is the timing of antibiotics that is important. If they are given early, I’m pretty sure the CDC can stop the outbreak. Otherwise if they delayed treatment, we might expect a few more cases coming up.” Kam said the CDC was experienced in handling cases of the plague and also had several monitoring stations in remote regions of China such as Yunnan province near the Vietnam border, where wild animals were particularly prone to getting infected. “For humans, the most dangerous part of catching pneumonic plague is when the patient is coughing out the bacteria from his or her lungs,” he said. Chaoyang Hospital declined to comment and calls to Beijing Ditan Hospital, a specialist hospital for infectious diseases, went unanswered.